41D0931168 CLIA NUMBER - HERMAN AYVAZYAN MD

Laboratory Demographics

  • CLIA Code: 41D0931168
  • Facility Name: HERMAN AYVAZYAN MD
  • Facility Address: 450 VETERANS MEMORIAL PKWY #12
    EAST PROVIDENCE, RI
    ZIP 02914
  • Facility Phone: 401 434-6464
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HERMAN AYBVAZYAN MD
  • NPI Number: 1417910555
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 41D0931168
LAB Type Physician Office
Facility Name HERMAN AYVAZYAN MD
Street 450 VETERANS MEMORIAL PKWY #12
City EAST PROVIDENCE
State RI
ZIP 02914
Phone 401 434-6464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Physician Office
Lab Director HERMAN AYBVAZYAN MD

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This page was last updated on: 9/29/2025